Ophthalmologic image display apparatus, ophthalmologic image display method, program, and storage medium

ABSTRACT

An ophthalmologic image display apparatus for displaying information about an eye includes an input unit configured to input a tomographic image of the eye, an acquisition unit configured to acquire diagnostic supporting information associated with positional information about the tomographic image of the eye, a processing unit configured to perform processing for assigning a voxel value to volume data constituting the tomographic image based on a reflection intensity value indicating the tomographic image and the diagnostic supporting information, and a display control unit configured to cause a display unit to display an image processed by the processing unit.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. patent application Ser. No.13/028,012 filed Feb. 15, 2011, which claims priority to Japanese PatentApplication No. 2010-264221 filed Nov. 26, 2010, and Japanese PatentApplication No. 2010-032696 filed Feb. 17, 2010, each of which arehereby incorporated by reference herein in their entireties.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a technique for displaying anophthalmologic image for use in, for example, an ophthalmologic medicalcare.

2. Description of the Related Art

An imaging apparatus referred to as an optical coherence tomography(hereinafter referred to as “OCT”) has enabled acquisition of athree-dimensional retina image formed by volume rendering based on aplurality of two-dimensional tomographic images obtained by scanning anentire retina. It is known that a large number of fundus diseases suchas glaucoma cause abnormality in the structure of a retina, andtherefore the OCT is expected to be effective for a diagnosis of adisease and a follow-up observation in the ophthalmologic medical field.Further, in recent years, the OCT has been used in imaging not only afundus diagnosis but also an anterior eye portion such as a cornea.

In a tomographic image, a value of a reflection intensity of light from,for example, a retina is observed as an image. Therefore, a tomographicimage is suitable for an observation of a tissue, but may be difficultto be used to grasp, for example, a change in a tissue over time, anoverall spread of a disease, and a portion to be focused on, without anadditional help.

Japanese Patent Application Laid-Open No. 2009-66015 discusses atechnique which displays a tomographic image and layer thicknessdistribution information arranged side by side. Using the technique, thelayer thickness distribution information and the tomographic image canbe compared. Japanese Patent Application Laid-Open No. 2009-66015further discusses a method for indicating a vascular territory. If avessel exists in a retina, the light of the OCT cannot reach a deepportion, resulting in generation of a low-quality tomographic image.Therefore, Japanese Patent Application Laid-Open No. 2009-66015indicates a need for a user to observe a retina while taking this matterinto consideration.

However, the method discussed in Japanese Patent Application Laid-OpenNo. 2009-66015 can be used for comparison between a tomographic imageand a layer thickness, and it is difficult to grasp, for example, howmuch a lesion has progressed from the tomographic image by this method.

SUMMARY OF THE INVENTION

The present invention is directed to a system for supporting a doctor'sdiagnosis by adding easily understandable diagnostic supportinginformation to a retina image formed by volume rendering. Further, thepresent invention is directed to providing diagnostic supportinginformation based on layer thicknesses of corresponding portions in acurrent retina image and a previously captured retina image.

According to an aspect of the present invention, an ophthalmologic imagedisplay apparatus for displaying information about an eye includes aninput unit configured to input a tomographic image of the eye, anacquisition unit configured to acquire diagnostic supporting informationassociated with positional information about the tomographic image ofthe eye, a processing unit configured to perform processing forassigning a voxel value to volume data constituting the tomographicimage based on a reflection intensity value indicating the tomographicimage and the diagnostic supporting information, and a display controlunit configured to cause a display unit to display an image processed bythe processing unit.

Further features and aspects of the present invention will becomeapparent from the following detailed description of exemplaryembodiments with reference to the attached drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of the specification, illustrate exemplary embodiments, features,and aspects of the invention and, together with the description, serveto explain the principles of the invention.

FIG. 1 illustrates a functional configuration of an ophthalmologic imagedisplay apparatus.

FIG. 2 illustrates a configuration of apparatuses connected to theophthalmologic image display apparatus.

FIG. 3 schematically illustrates a layer structure in a tomographicimage of a retina.

FIGS. 4A and 4B schematically illustrate a retina image with adifference in layer thickness superimposed thereon.

FIG. 5 is a flowchart illustrating a processing procedure of theophthalmologic image display apparatus.

FIG. 6 schematically illustrates a retina image with a difference from astandard layer thickness superimposed thereon.

FIG. 7 is a flowchart illustrating a processing procedure of theophthalmologic image display apparatus.

DESCRIPTION OF THE EMBODIMENTS

Various exemplary embodiments, features, and aspects of the inventionwill be described in detail below with reference to the drawings.

The description which will be provided below is about exemplaryembodiments of an ophthalmologic image display apparatus according tothe present invention, and it should be noted that these embodiments arenot intended to limit the present invention.

FIG. 1 illustrates a configuration of an ophthalmologic image displayapparatus 1 according to a first exemplary embodiment. Theophthalmologic image display apparatus 1 includes an acquisition unit11, a processing unit 12, and a display control unit 13.

In the present exemplary embodiment, the acquisition unit 11 measureslayer thicknesses of a retina from tomographic images of the retinacaptured at different points in time, or acquires the measured results.A plurality of two-dimensional tomographic images of a retina can beacquired by scanning the retina a plurality of times. The tomographicimage of the retina is constituted based on a value indicating intensityof light reflected by the eye. A three-dimensional retina tomographicimage is formed from the plurality of two-dimensional retina tomographicimages. Then, the value indicating the light intensity of thetwo-dimensional retina tomographic image is assigned to each voxel as avoxel value to obtain volume data.

Then, a difference between the layer thicknesses in the correspondingtomographic images captured at different points in time is acquired as adifference value. The processing unit 12 adds diagnostic supportinginformation to the volume data based on the difference value as thediagnostic supporting information. The display control unit 13 controlsa monitor, which is a not-shown display unit, to display the imageprocessed by the processing unit 12.

The ophthalmologic image display apparatus 1 can support a diagnosis ofa doctor by, for example, enabling the doctor to easily locate a portionto be compared by the above-described way. More specifically, a boundaryof a nerve fiber layer (hereinafter referred to as “NFL”) is extractedfrom each of the tomographic images or volume data of a same subjectcaptured at different time points to measure a thickness of the NFLtherein. Next, a difference between the extracted NFL thicknesses iscalculated. A color corresponding to the difference value is applied toa pixel in the volume data or the tomographic image based on thecalculated value of the difference in layer thickness, and the coloreddata is displayed. Accordingly, it is possible to easily locate andcompare a portion where the layer thickness is changed over time due toa disease. In the following, one usage of the present exemplaryembodiment will be described in which a layer thickness of an NFL isused as a comparison target. However, information added to volume dataor a tomographic image is not limited to the layer thickness of an NFL.The ophthalmologic image display apparatus 1 may measure a thickness ofanother layer constituting a retina or a cornea, or a thickness of aretina or a cornea as a whole, and use it as a comparison target.

FIG. 2 illustrates a configuration of apparatuses connected to theophthalmologic image display apparatus 1 according to the presentexemplary embodiment. As illustrated in FIG. 2, the ophthalmologic imagedisplay apparatus 1 is connected to a tomographic image capturingapparatus 2 and a data server 3 via a local area network (LAN) 4 such asthe Ethernet (registered trademark). The tomographic image capturingapparatus 2 is an apparatus for capturing a tomographic image of an eye,and is embodied by, for example, an OCT. Since an OCT acquires atomographic image of each scanning line by one imaging operation, it ispossible to acquire tomographic images corresponding to a plurality ofscanning lines. Volume data of a retina can be acquired by arrangingthese tomographic images in the captured order.

The tomographic image capturing apparatus 2 captures a tomographic imageof a subject (patient) according to an operation of a user (technicianor doctor), and outputs acquired volume data to the ophthalmologic imagedisplay apparatus 1. Further, the ophthalmologic image display apparatus1 may be configured to be connected to the data server 3 storing thevolume data acquired by the tomographic image capturing apparatus 2 toobtain required volume data from the data server 3. The ophthalmologicimage display apparatus 1 may be connected to those apparatuses via aninterface such as a universal serial bus (USB) or Institute ofElectrical and Electronics Engineers (IEEE) 1394. Further, theophthalmologic image display apparatus 1 may be connected to thoseapparatuses via an external network such as the Internet with use of theLAN 4.

Next, a processing procedure of the ophthalmologic image displayapparatus 1 according to the present exemplary embodiment will bedescribed with reference to the flowchart illustrated in FIG. 5.

In step S501, first, the acquisition unit 11 acquires a plurality ofpieces of volume data acquired by the tomographic image capturingapparatus 2 or volume data stored in the data server 3 that werecaptured at different time points. For convenience of description, it isassumed that, as the coordinate system of volume data, a horizontaldirection of a tomographic image is an X axis and a vertical directionof a tomographic image is a Y axis.

Next, an inner limiting membrane (hereinafter referred to as “ILM”), alower end of an NFL layer, and a retinal pigment epithelium (hereinafterreferred to as “RPE”) are extracted from each volume data, asillustrated in the retina schematic diagram in FIG. 3. For acquiringboundaries among these layers, edge components are detected from theretina volume data, and several lines are extracted as candidates of thelayer boundaries based on connectivity of the edge components. Anuppermost line is selected as an ILM boundary, and the next line isselected as an NFL boundary from those candidates.

A method for extracting the layer boundaries is not limited to theabove-described method, and may be realized by any method capable ofextracting the boundaries among the layers from retina volume data.Finally, a thickness between the ILM and the lower end of the NFL isacquired from the extraction results as the layer thickness of the NFL.

In step S502, the acquisition unit 11 calculates the difference in thelayer thickness in the X coordinate by subtracting the layer thicknessof the NFL layer in the X coordinate in one piece of volume data fromthe thickness of the NFL in the X coordinate in another piece of volumedata. Here, it is assumed that these two pieces of volume data is datacapturing a same position, or their positions are adjusted and theircoordinate systems correspond to each other. The position adjustment ofthe volume data pieces can be performed by a known method, for example,a method with use of a correlation coefficient. The processing in stepS502 enables acquisition of the difference in the layer thickness, i.e.,the difference between the thicknesses of the layers as the diagnosticsupporting information associated with positional information of thevolume data or the tomographic image of the eye.

In step S503, volume rendering is realized by applying opacity to thevoxel value of each voxel.

In step S504, color and opacity according to the difference are appliedto the pixels in each volume data or pixels from the ILM to RPE in thetomographic image as illustrated in FIG. 4, and the applied color andopacity are displayed. In glaucoma or another disease that causesreduction in the layer thickness as the disease progresses, for example,the color and the opacity may be set so that a portion with a largedifference in the layer thickness becomes redder, and has a largeropacity than a value determined based on the voxel value. As a result,the tomographic image is displayed in such a manner that a portion witha significantly reduced layer thickness becomes redder and more opaque.On the other hand, a portion with a slightly or seldom reduced thicknessis displayed as the tomographic image formed using the voxel value ofthe volume data without any change. Further, for a portion with anincreased thickness as time has passed, the color and the opacity can beset so that the portion with a larger difference in layer thicknessbecomes bluer, and has a larger opacity.

As a result, the tomographic image is displayed in such a manner that aportion with a significantly increased layer thickness becomes bluer andmore opaque. On the other hand, a portion with a slightly or seldomincreased thickness is displayed as the tomographic image formed usingthe voxel value of the volume data without any change. A portion inwhich a change in the layer thickness is smaller than a predeterminedvalue is displayed using the voxel value as it is. When the processingin steps S503 and S504 are executed for all voxels of the volume data,the color can be superimposed and displayed onto the portion with asignificant change in the layer thickness in the tomographic image.

Since it is extremely important to find an object to be closely observedfrom volume data, addition of information onto a tomographic image iseffective.

Then, the display control unit 13 performs display control so that themonitor as the not-illustrated display unit displays the image processedby the processing unit 12.

According to the present exemplary embodiment configured as describedabove, it is possible to easily recognize and compare, on thetomographic image, a position and a change amount of the layer thicknessof a portion where a disease has progressed or a portion where atreatment has succeeded.

The present exemplary embodiment is described based on an example ofmeasuring the layer thicknesses in two pieces of the volume data in stepS501, and indicating the difference between the layer thicknesses on thetomographic image. However, the present invention is not limited to thisexample. For example, the ophthalmologic image display apparatus 1 maymeasure the thicknesses of the layers in three pieces of volume data A,B, and C, and indicate, on the tomographic image, whether a speed of thechange in the layer thickness increases or decreases by subtracting thedifference between the layer thicknesses in the volume data pieces B andC from the difference between the layer thicknesses in the volume datapieces A and B. In this case, the color and the opacity may be set sothat a portion with a large difference in the layer thickness becomesbluer and more opaque. Accordingly, a portion in which a rate ofprogression of disease becomes slower may be displayed bluer and moreopaque. On the other hand, a portion in which the rate of progression ofdisease is less changed may be displayed using the voxel value of thevolume data as it is. As a result, a doctor can easily confirm a portionwhere a treatment by a medication or an operation has exerted a rapideffect, and predict the progress of the change in the layer thickness.

In the present exemplary embodiment, the ophthalmologic image displayapparatus 1 compares the volume data pieces captured by the tomographicimage capturing apparatus 2. However, the ophthalmologic image displayapparatus 1 may prepare a standard layer thickness of a retina bycalculating, for example, an average value, an intermediate value, or amode as statistics information from results of layer thicknessmeasurements conducted on a plurality of healthy eyes. In this case, theophthalmologic image display apparatus 1 measures a layer thickness inone piece of the volume data in step S501, and calculates a differencebetween the standard layer thickness and the measured layer thickness instep S502. As a result, the ophthalmologic image display apparatus 1 canindicate a portion deviating from a normal range of the layer thicknesson the tomographic image, as illustrated in FIG. 6.

In this case, the line of the RPE and the line of the normal ILM may bedisplayed on the tomographic image. Further the color and opacity may beset so that a portion with a large difference in the layer thicknessfrom the standard layer thickness prepared in advance becomes redder andmore opaque. As a result, a portion with a layer thickness significantlydeviating from the standard layer thickness can be displayed redder andmore opaque. On the other hand, a portion with a similar layer thicknessto the standard layer thickness can be displayed using the voxel valueof the volume data as it is. Accordingly, a doctor can compare theretina of a patient with a healthy eye on the tomographic image torecognize how much the condition of the retina of the patient has grownworse compared to the healthy eye. In addition, It is possible tocalculate the difference between the thicknesses of the correspondinglayers by normalizing a size of the tomographic image.

A second exemplary embodiment will be described based on an example of amethod for performing volume rendering with use of volume data and layerthickness difference information. Volume rendering is a method forthree-dimensionally visualizing, for example, an inner structure and aspatial distribution of temperature of an object displayed in the volumedata by arbitrarily designing a transfer function for setting a colorand an opacity. In the present exemplary embodiment, volume rendering isperformed by designing a transfer function for setting a color and anopacity based on a layer thickness and a luminance value.

A processing procedure of the ophthalmologic image display apparatus 1according to the present exemplary embodiment will be described withreference to the flowchart illustrated in FIG. 7. The processing similarto the processing illustrated in FIG. 5 will not be repeated here.

In step S703, the processing unit 12 designs transfer functions for adifference in the layer thickness and for a luminance value(corresponding to a value of a tomographic image). First, the transferfunction for the difference in the layer thickness is designed in thefollowing manner. More specifically, the transfer function for thedifference in the layer thickness is designed so that the opacity of aportion in which the difference in the layer thickness is smaller than apredetermined value is set at a low level and to be gradually increased,and the opacity of a portion in which the difference in the layerthickness is larger than the predetermined value is set at a high leveland to be rapidly increased. Further, the transfer function for theluminance value is designed so that the opacity is set at a low leveland gradually increased and the color changes to blue, green, and red asthe luminance value increases.

The design of the transfer functions and execution of volume renderingaccording thereto can result in such a display that the color becomesredder as the luminance value increases, and a portion with a largedifference in the layer thickness becomes more opaque. Further, sincethe opacity is also set from the luminance value, it is possible todisplay three-dimensional distribution of a portion in which thedifference in the layer thickness becomes larger in the entire retina.

In step S704, further, the processing unit 12 performs the volumerendering with use of the transfer functions designed in step S703.

According to the present exemplary embodiment configured as describedabove, it is possible to provide a display effective for a follow-upobservation of an entire retina with use of a three-dimensional image byvisualizing the three-dimensional distribution and the change amount ofthe layer thickness with respect to a portion where a disease hasprogressed and a portion where a treatment has exerted some effect.

In the above described respective exemplary embodiments, the presentinvention is embodied as the ophthalmologic image display apparatus.However, the exemplary embodiments of the present invention are notlimited to the ophthalmologic image display apparatus. The presentinvention may be embodied in the form of, for example, a systemconstituted by a plurality of apparatuses, a device constituted by oneapparatus, software and a program to be executed on a computer, or astorage medium such as an optical disk.

While the present invention has been described with reference toexemplary embodiments, it is to be understood that the invention is notlimited to the disclosed exemplary embodiments. The scope of thefollowing claims is to be accorded the broadest interpretation so as toencompass all modifications, equivalent structures, and functions.

What is claimed is:
 1. An apparatus comprising: at least one memory; andat least one processor configured to perform operations comprising:extracting corresponding retinal layers in at least two of tomographicimages of a retina of an eye captured at different times; measuringretinal layer thicknesses of the extracted corresponding retinal layers;acquiring information indicating a difference between the measuredretinal layer thicknesses; determining, as a partial region of thecorresponding retinal layers, a region where the difference is largerthan a threshold in at least one of the tomographic images; determining,based on the acquired information indicating the difference, a firstcolor to a portion in which a retinal layer thickness is increased and asecond color to a portion in which a retinal layer thickness is reduced;and causing a display unit to display at least one of the tomographicimages, wherein the determined first and second colors are superimposedon the determined partial region of the at least one of the tomographicimages.
 2. The apparatus according to claim 1, wherein the at least twoof tomographic images are two-dimensional tomographic images obtained byscanning the retina and using light reflected by the retina along anoptical axis.
 3. The apparatus according to claim 1, wherein the atleast two of tomographic images are three-dimensional tomographic imagesobtained by scanning the retina including a plurality of two-dimensionalimages acquired by capturing two-dimensional images along an opticalaxis a plurality of times and using light reflected by the retina alonga direction intersecting the optical axis.
 4. The apparatus according toclaim 1, wherein the determining unit determines a larger opacity as achange in the layer thickness with the passage of time increases.
 5. Theapparatus according to claim 1, wherein the determining unit uses anintensity value of the tomographic image as it is for a portion in whicha change in the layer thickness with the passage of time is small, setsdifferent colors to a portion in which a layer thickness is increasedand a portion in which a layer thickness is reduced, and sets a largeropacity as the difference in the layer thickness increases.
 6. Theapparatus according to claim 1, wherein the determining unit determinescolors at different positions in the at least one of the tomographicimages based on the acquired information indicating the difference, andwherein the display control unit causes the display unit to display theat least one of the tomographic images using the determined colors. 7.The apparatus according to claim 1, wherein the corresponding retinallayers are nerve fiber layers of the eye.
 8. A method comprising:extracting corresponding layers in at least two of tomographic images ofa retina of an eye captured at different times; measuring retinal layerthicknesses of the extracted corresponding retinal layers; acquiringinformation indicating a difference between the measured retinal layerthicknesses; determining, as a partial region of the correspondingretinal layers, a region where the difference is larger than a thresholdin at least one of the tomographic images; determining, based on theacquired information indicating the difference, a first color to aportion in which a retinal layer thickness is increased and a secondcolor to a portion in which a retinal layer thickness is reduced; andcausing a display unit to display at least one of the tomographicimages, wherein the determined first and second colors are superimposedon the determined partial region of the at least one of the tomographicimages.
 9. A non-transitory computer-readable storage medium for storinga computer program for causing a computer to execute a method accordingto claim
 8. 10. The method according to claim 8, wherein the at leasttwo of tomographic images are two-dimensional tomographic imagesobtained by scanning the retina and using light reflected by the retinaalong an optical axis.
 11. The method according to claim 8, wherein theat least two of tomographic images are three-dimensional tomographicimages obtained by scanning the retina including a plurality oftwo-dimensional images acquired by capturing two-dimensional imagesalong an optical axis a plurality of times and using light reflected bythe retina along a direction intersecting the optical axis.
 12. Themethod according to claim 8, wherein a larger opacity is determined as achange in the layer thickness with the passage of time increases. 13.The method according to claim 8, wherein in determining opacities anintensity value of the tomographic image is used as it is for a portionin which a change in the layer thickness with the passage of time issmall, different colors are set to a portion in which a layer thicknessis increased and a portion in which a layer thickness is reduced, and alarger opacity is set as the difference in the layer thicknessincreases.
 14. The method according to claim 8, wherein colors atdifferent positions in the at least one of the tomographic images aredetermined based on the acquired information indicating the difference,and wherein the display unit is caused to display the at least one ofthe tomographic images using the determined colors.
 15. The methodaccording to claim 8, wherein the corresponding layers are nerve fiberretinal layers of the eye.